Adding Coronary Computed Tomography Angiography to Invasive Coronary Angiography Improves Prediction of Cardiac Events

Kawai, Hideki; Motoyama, Sadako; Sarai, Masayoshi; Ito, Hajime; Harigaya, Hiroto; Kan, Shino; Ishii, Junichi; Anno, Hirofumi; Murohara, Toyoaki

doi:10.1253/circj.cj-14-0743

Cited by 10 publications

(4 citation statements)

References 36 publications

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“…On the basis of this result, we reported that HRP showing positive remodeling and/or low attenuation was associated with the development of ACS in the future 8 , 9 ) . Furthermore, the CTA detection of HRP enhanced the predictive accuracy of the clinical and angiographic characteristics for future coronary events 18 ) . Finally, statin treatment for HRP results in decreases in the plaque and necrotic core volume 30 ) .…”

Section: Discussionmentioning

confidence: 99%

“…Coronary arterial remodeling was defined as a change in the vessel area at the plaque site in comparison with the reference segment set proximal to the legion in a normal-appearing vessel segment (reference area). The remodeling index was reported as positive when the area at the plaque site was at least 20% larger than the reference segment 16 – 18 ) .…”

Section: Methodsmentioning

confidence: 99%

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Noninvasive Assessment of Stenotic Severity and Plaque Characteristics by Coronary CT Angiography in Patients Scheduled for Carotid Artery Revascularization

Hoshino

Kawai

Sarai

et al. 2018

JAT

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Aims: Coronary artery atherosclerosis in patients needing carotid revascularization has not been fully clarified. The aim of this study was to evaluate the stenotic severity and plaque characteristics of coronary arteries by coronary computed tomography angiography (CTA) in patients scheduled for carotid-artery stenting (CAS) or carotid endarterectomy (CEA).Methods: We performed coronary CTA after carotid ultrasound (US) in 164 patients (81.7% male, aged 68.1 ± 12.2 years) from 2014 to 2016. Of all, 70 were scheduled for CAS or CEA (CAS/CEA group) and 94 were not (non-CAS/CEA group). Carotid US and coronary CTA were compared for the evaluation of stenotic severity and plaque characteristics of each vessel between CAS/CEA and non-CAS/CEA groups.Results: Between the two groups, there were significant differences in the presence of significant stenosis (SS: ≥ 70% stenosis of coronary artery) (55.7% vs. 39.4%, P = 0.038), triple-vessel disease (TVD)/left main trunk (LMT) (SS in each of three epicardial vessels and/or LMT) (24.3% vs. 7.5%, P = 0.0025), and high-risk plaque (HRP: positive remodeling and/or low attenuation) (55.7% vs. 24.5%, P < 0.0001). CAS/CEA was independently associated with TVD/LMT (OR = 2.30, 95%CI: 1.14–8.59, P = 0.026) and HRP (OR = 3.17, 95%CI: 1.57–6.54, P = 0.0012) in multivariable logistic regression analysis. Similarly, vulnerable plaque (78.6% vs. 2.1%, P < 0.0001) as well as severe stenosis of carotid artery (98.6% vs. 0%, P < 0.0001) was seen more often in CAS/CEA than in non-CAS/CEA group.Conclusions: The prevalence of TVD/LMT and HRP determined by coronary CTA is higher in patients needing CAS/CEA than in those without. Management of systemic atherosclerosis is required in the perioperative period of CAS/CEA.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Noninvasive Assessment of Stenotic Severity and Plaque Characteristics by Coronary CT Angiography in Patients Scheduled for Carotid Artery Revascularization

Hoshino

Kawai

Sarai

et al. 2018

JAT

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“…44 Coronary Computed Tomographic Angiography CTA is useful for the detection of coronary artery calcium burden, as well as for the detection of relevant epicardial stenosis. 45 Several reports have highlighted the usefulness of CTA in the evaluation of patients with vasospastic angina. In some cases, CTA showed a relevant stenosis that was later cules responsible for modulation of vascular tone have also been suggested.…”

Section: Coronary Angiographymentioning

confidence: 99%

Structural and Functional Coronary Artery Abnormalities in Patients With Vasospastic Angina Pectoris

Ong

Aziz

Hansen

et al. 2015

Circ J

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Coronary spasm is involved in many clinical scenarios, such as stable angina, acute coronary syndrome, sudden cardiac death, non-ischemic cardiomyopathy, arrhythmia and syncope. In recent years, imaging tools such as computerized tomographic angiography, intravascular ultrasound or optical coherence tomography have been applied to study the coronary pathology in patients with vasospastic angina. Patients with vasospastic angina represent a heterogeneous cohort of patients with regard to the extent of concomitant coronary atherosclerosis. They share the common pathophysiological phenomenon of vascular smooth muscle hyperreactivity leading to spasm caused by various factors that may also overlap. Focal coronary spasm is related to epicardial atherosclerosis and in the presence of obstructive coronary artery disease it may be useful to treat the lesion to prevent further spasm. The aim of this article is to review structural and functional coronary artery abnormalities in patients with vasospastic angina. (Circ J 2015; 79: 1431 -1438

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“…The "napkin-ring sign" on coronary CT angiography (CTA) is clinically important because it is an established CT feature of a high-risk coronary plaque associated with acute coronary syndrome [1][2][3]. Recent practice guidelines stated that the napkinring sign should be reported as one of the characteristics of a vulnerable plaque in the Coronary Artery Disease-Reporting and Data System (CAD-RADS) [4].…”

Section: Introductionmentioning

confidence: 99%

Napkin-Ring Sign on Coronary Computed Tomography Angiography-Tiered Enhancement of Coronary Lumen and Plaque

Utsunomiya

Hokimoto

Kanemaru

et al. 2017

Cardiovasc Imaging Asia

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We present the case of an 85-year-old man showing the "napkin-ring sign" tiered enhancement pattern on dual-phase coronary CT angiography using a 320-row multidetector CT. This has not been previously reported. In the first-phase scan, only the coronary arterial lumen was opacified. In the second-phase scan, not only the coronary arterial lumen but also the plaque margin was clearly enhanced (the "napkin-ring sign"). We considered that the tiered enhancement pattern might reflect the pathology of the "napkin-ring sign" which includes a necrotic core in the center of a plaque surrounded by fibrosis with proliferation of microangiotextures.

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Adding Coronary Computed Tomography Angiography to Invasive Coronary Angiography Improves Prediction of Cardiac Events

Cited by 10 publications

References 36 publications

Noninvasive Assessment of Stenotic Severity and Plaque Characteristics by Coronary CT Angiography in Patients Scheduled for Carotid Artery Revascularization

Noninvasive Assessment of Stenotic Severity and Plaque Characteristics by Coronary CT Angiography in Patients Scheduled for Carotid Artery Revascularization

Structural and Functional Coronary Artery Abnormalities in Patients With Vasospastic Angina Pectoris

Napkin-Ring Sign on Coronary Computed Tomography Angiography-Tiered Enhancement of Coronary Lumen and Plaque

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